Individual provider Active NPI

John M Biltz, MD

  • Dermatology Physician
  • Corsicana, TX
National Provider Identifier
1225001860
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
J6338 Issued in TX
Practice address
401 Hospital Dr
Suite 100
Corsicana, TX 75110-2415
Phone
(903) 875-0413
Fax
(903) 872-8165
NPI assigned
Feb 13, 2006
Last updated
May 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X J6338 TX Primary

Addresses

Primary practice location

401 Hospital Dr
Suite 100
Corsicana, TX 75110-2415

Mailing address

401 Hospital Dr
Suite 100
Corsicana, TX 75110-2415
Phone (903) 875-0413

Other identifiers 2

IdentifierTypeStateIssuer
039388602MedicaidTX
P00433438OtherTXMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050708000714 TX Practitioner - Dermatology 1557397882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Southwestern Medical School at Dallas, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1367 Dominion PLZ
Tyler, TX 75703-1013
Phone (903) 534-6200

401 Hospital Dr
Suite 100
Corsicana, TX 75110-2415
Phone (903) 875-0413

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions2150
Removal or shaving of skin growth82
Skin biopsy309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J6338TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. Dermatology CurrentSince Sep 1, 2016 Accepting new patients

Locations

401 Hospital Dr
Ste 100
Corsicana, TX 75110
Phone (903) 875-0413

5310 Harvest Hill Rd
Ste 290
Dallas, TX 75230
Phone (214) 420-0672

1367 Dominion Plz
Tyler, TX 75703
Phone (903) 534-6200

Interoperability endpoints

  • Direct secure messaging: john.biltz.1@7873.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1225001860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HOSPITAL DR",
            "address_2": "SUITE 100",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102415",
            "telephone_number": "903-875-0413",
            "fax_number": "903-872-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOSPITAL DR",
            "address_2": "SUITE 100",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102415",
            "telephone_number": "903-875-0413",
            "fax_number": "903-872-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILTZ",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "J6338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039388602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00433438",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.